Individual
MRS. TERESITA AGUSTIN COMETA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5471 DR MARTIN LUTHER KING DR, SAINT LOUIS, MO 63112-4265
(314) 367-5820
(314) 367-6326
Mailing address
5471 DR MARTIN LUTHER KING DR, SAINT LOUIS, MO 63112-4265
(314) 367-5820
(314) 367-6326
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
36120
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201200272
—
MO
05
—
201400280
—
MO
Enumeration date
08/09/2005
Last updated
10/06/2011
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